South Carolina insurance laws

What it would do: Requires owners of watercraft over 70 horsepower, personal watercraft, or specialty propcraft titled in South Carolina to carry liability insurance with minimum $50,000 combined coverage per occurrence. Establishes misdemeanor penalties of $50-$250 for first/second offenses and $500-$1,000 or up to one year imprisonment for subsequent offenses.

What it would do: Requires health insurers using artificial intelligence for prior authorization decisions to base determinations on enrollees' medical history and clinical circumstances, obtain annual departmental certification of compliance, and ensure a licensed physician makes final denial decisions. Mandates disclosure to enrollees and establishes Department of Insurance enforcement authority.

What it would do: Establishes an Insurance Fraud Division in the Department of Insurance to prosecute insurance fraud crimes. Prohibits residential builders and contractors from representing property owners on insurance claims or rebating deductibles, and restricts automobile insurers from denying coverage or raising rates based on uninsured motorist claims occurring within thirty-six months.

What it would do: Requires owners of watercraft anchored in South Carolina coastal waters for more than fourteen days to obtain a marine survey from a licensed surveyor certifying seaworthiness and display a sticker; violations are misdemeanors punishable by up to five hundred dollars or thirty days imprisonment.

What it would do: Requires insurers issuing residential property insurance policies in South Carolina to communicate in at least ten point boldface type at policy issuance and each renewal that the policy does not cover earthquake losses and direct insureds to inquire about earthquake coverage options.

What it would do: Amends Section 42-1-560 to make filing a notice form permissive rather than mandatory when commencing a third-party workers' compensation action, and clarifies the timeline and procedures for carrier assignment of such actions.

What it would do: Establishes an alcohol server training program requiring certification for on-premises alcohol servers, creates civil liability for licensees who knowingly serve visibly intoxicated persons, increases liquor liability insurance requirements to $500,000-$1,000,000, and modifies joint and several liability rules in tort cases.

What it would do: Reforms tort liability by modifying joint and several liability rules, creating a dram shop cause of action against alcohol licensees, requiring alcohol server training and certification, and adjusting damages caps and insurance requirements for various liability contexts.

What it would do: Requires health insurance policies in South Carolina to cover diagnostic and supplemental breast examinations without cost-sharing requirements, with exceptions for Health Savings Account-qualified high deductible health plans regarding deductibles.

What it would do: Requires pharmacy benefits managers to provide unobstructed access to their Maximum Allowable Cost Lists to patients, consumers, network pharmacies, and all subject pharmacies, and to update lists at least weekly.

What it would do: Requires health benefit plan issuers to provide written notice at least 60 days before modifying drug coverage, including removing drugs, adding prior authorization, imposing quantity limits, implementing step-therapy, or moving drugs to higher cost-sharing tiers without generic alternatives.

What it would do: Allows a rental vehicle renter to agree in the rental agreement that the renter's automobile liability insurance will pay up to its policy limits before the rental company must pay in the event of an accident.

What it would do: Repeals Section 61-2-145 of the South Carolina Code, which relates to required liability insurance coverage. The act takes effect upon approval by the Governor.

What it would do: Prohibits insurers from using certain demographic factors or HIV prevention treatment use to make underwriting decisions, set rates, or impose coverage limitations, and requires the Director of Insurance to review positive HIV test results upon appeal.

What it would do: Requires insurers and pharmacy benefit managers to include all cost-sharing amounts paid by or on behalf of enrollees when calculating annual cost-sharing limitations under federal law, with exceptions for generic drugs and preventive care, effective for health plans entered into or renewed on or after January 1, 2026.

What it would do: Enacts the Patients' Right to Transparency and Timely Access to Healthcare Services Act, establishing requirements for health carriers regarding prior authorization processes, timelines, step therapy exceptions, prescription drug coverage restrictions, and continuity of care when patients change insurance plans.

What it would do: Amends sections 38-71-2250 and 38-71-2340 to provide that examinations of pharmacy benefits managers and pharmacy services administrative organizations are subject to the requirements of Chapter 13, Title 38.

What it would do: Renames the South Carolina Hurricane Damage Mitigation Program to the SC Safe Home Program and revises grant eligibility, award amounts, and allocation procedures, including establishing needs-based prioritization for grants and authorizing annual bulletin-based allocations.

What it would do: Prohibits life, health, accident and health, and long-term care insurers from requiring genetic testing, requiring complete genome sequencing, or canceling, limiting, or denying coverage based solely on genetic information without signed written consent. Amends disability income insurance provisions to prohibit discrimination based solely on genetic information.

What it would do: Requires health insurers using artificial intelligence for prior authorization decisions to base determinations on enrollees' medical history and clinical circumstances, obtain annual departmental certification of compliance, and ensure a licensed physician makes final denial decisions. Mandates disclosure to enrollees and allows the Department of Insurance to impose corrective plans or disciplinary measures for violations.

What it would do: Amends pharmacy benefits manager regulations to prohibit spread pricing, patient steering without disclosure, retroactive claim denials, discriminatory reimbursement rates, and other unfair trade practices, while requiring rebate transparency and early refill allowances for maintenance drugs.

What it would do: Requires workers compensation claim forms and benefit denial forms to include explicit notices about nonrepresentation, appeals rights, deadlines, filing procedures, contact information for the commission, representation options, and statute of limitations. The commission must revise forms by January 1, 2027.

What it would do: Increases administrative penalties for insurance law violations by insurers, pharmacy benefits managers, and health maintenance organizations from fifteen thousand to twenty-five thousand dollars, or thirty to two hundred fifty thousand dollars for willful violations. Increases pharmacy benefits manager license application fees from one to twenty-five thousand dollars and renewal fees from five hundred to ten thousand dollars.

What it would do: Defines contingent deferred annuity as an annuity contract where the insurer's obligation to make lifetime payments is triggered when designated investments are depleted to a contractually defined amount. Exempts contingent deferred annuities from standard nonforfeiture law requirements but allows the Department of Insurance to promulgate regulations for nonforfeiture benefits at the director's discretion.

What it would do: Requires coastal multi-story buildings at least 15 years old to undergo full structural inspections by certified structural experts every five years as a condition of property insurance renewal, and allows insurers to consider inspection findings when deciding whether to renew policies.